BLAKE A ANDERSON Athletic Trainer License verification

Business Entity

ACTIVE

License Type

Athletic Trainer

Description

LICENSED ATHLETIC TRAINER

License Number

096004964

License Status

ACTIVE

Business

First Name

BLAKE

Middle

Last Name

ANDERSON

Business Name

BLAKE A ANDERSON

Original Issue Date

08/16/2019

Effective Date

04/10/2024

Expiration Date

05/31/2026

City

DAVENPORT

State

Zip

52801

Ever Disciplined

LastModifiedDate

03/04/2026